Pearson Edexcel Level 3 Advanced GCE in Religious Studies – Anthology
52ii) Double effec t
Another indirec t argument has a long tradition in Natural Law ethic s and involves
two kinds of intention. Ac c ording to the double effec t (DDE) argument there is a
difference between foreseeing an event and directly intending or willing it to
happen. The emphasis, therefore, is different from the ac t and omissions argument
where the agent foresaw what was to happen and allowed it to happen. For
instanc e, A defend themselves against an attac k from B using reasonable forc e.
They know that this might result in B’s death but it is not their intention that this
should happen. If B then dies as a result of A’s defenc e the DDE does not hold A to
be blameworthy for an ac t they did not intend. In Case 3 a doctor who subscribes
to the DDE might argue that the princ iple is sound medic ine (and as a well-
est ablished princ iple in Nat ural Law et hic s it is t herefore ac c ept able in Roman
Cat holic t heology). However, the term ‘euthanasia’ is resisted in the same way that
‘abort ion’ is avoided for similar reasons. But is the DDE open to abuse?
...- Is there a satisfac tory distinc tion between intending and foreseeing? Might one
say that the DDE is bad medicine, that if I foresee death but fail to act, then
t his is an omission whic h is a form of indirec t eut hanasia – which is rejected by
the SOL?
iii) Ordinary and extraordinary means.
The princ iple of ordinary and extraordinary means is used both by weak SOL
(WSOL) arguments and QOL proponents. Another, possibly better way of
c onsidering t he issue is in t erms of proportionate and disproportionate me a n s.
- In the Natural law tradition a person who refuses food and water in order to die
has deliberat ely c ommit t ed suic ide whic h is c ondemned in Roman Cat holic
t heology as a mort al sin. But a person is within their rights to refuse surgery on
grounds that it is over and above what is needed ordinarily for bare existence.
The BMA for instanc e say, ‘c ompetent patients have a right to refuse any
t reat ment , inc luding life-prolonging treatment’ (Medic al Et hic s T oday, 1993,
p.149). Nat ure is allowed t o t ake it s c ourse. The doc tor is not involved in the
direc t c ause of death of the patient. T hose who c rit ic ise t his suggest it is a form
of passive euthanasia or even assisted suicide. For instance, if a doctor
wit hholds life-sustaining treatment, against his or her better judgement, but
through respec t for patient autonomy, the result might be c ondemned either as
an ac t of professional negligenc e or wilful killing. - On the other hand, some argue that it is a doc tor’s professional duty to use
whatever medicines are available regardless of t he sit uat ion. A response to this
might be to think in terms of proportion as an alternative variation of
ext raordinary means. Proport ion is a well-est ablished princ iple in t he Nat ural
Law t radit ion whic h may be applied t o medic ine wit hout c omp ro mis i n g t h e
obligation of the doctor to treat his or her patient. This enables eac h situation
to be seen individually so that what might be considered proportionate to
ac hieve good ends is c ontingent on the needs of the patient and even the
resources of the doctor. T he issue is part ic ularly c omplex wit h non-competent